Investigating a novel surrogate indicator of adipose accumulation in relation to erectile dysfunction

Abstract

Introduction: Although previous studies have linked obesity and erectile dysfunction, the novel surrogate indicators of adipose accumulation are more essential and dependable factors to consider. Therefore, the primary objective of the current investigation was to examine and clarify the association between metabolic score for visceral fat (METS-VF) and erectile dysfunction.

Methods: Firstly, multivariate logistic regression analysis, smoothed curve fitting, and threshold effect analysis were employed to investigate the association between METS-VF and erectile dysfunction. Mediation analysis was also performed to evaluate the mediating role of homocysteine and inflammation. After that, subgroup analysis was carried out to examine the stability of the correlation of METS-VF with erectile dysfunction in various population settings. Furthermore, the area under the receiver operating characteristic (ROC) curve and eXtreme Gradient Boosting (XGBoost) algorithm were utilized to assess the capability of identifying METS-VF in comparison to the other four obesity-related indicators in identifying erectile dysfunction.

Results: After adjusting for all confounding factors, METS-VF was strongly and favourablely correlated with erectile dysfunction. With each additional unit rise in METS-VF, the prevalence of erectile dysfunction increased by 141%. A J-shaped relationship between METS-VF and erectile dysfunction was discovered through smoothed curve fitting. Marital status, physical activity, and smoking status can potentially modify this association. This finding of the ROC curve suggests that METS-VF had a powerful identifying capacity for erectile dysfunction (AUC = 0.7351). Homocysteine and inflammation mediated 4.24% and 2.81%, respectively.

Conclusion: The findings of the current investigation suggest that METS-VF can be considered a dependable identifying indicator of erectile dysfunction.

Keywords: Erectile dysfunction; METS-VF; NHANES; Obesity.

Fig. 1

Flow chart of participants selection. NHANES, National Health and Nutrition Examination Survey

Fig. 2

Association between METS-VF and erectile dysfunction. Adjustments have been made for all covariates in the investigation. METS-VF, metabolism score for visceral fat

Fig. 3

Results of subgroup analysis. Adjustments have been made for all covariates in the investigation. OR, odds ratio; CI, Confidence interval

Fig. 4

Comparison of the predictive power for evaluation indicators of obesity. *When the AUC value of this indicator was compared to the AUC value of the METS-VF the result obtained was P < 0.05. METS-VF metabolism score for visceral fat, WC waist circumference, LAP lipid accumulation product, VAI visceral adiposity index, WHtR waist-to-height ratio, PPV positive predictive value, NPV negative predictive value

Fig. 5

Using XGBoost modeling to assess the relative importance of surrogate indicators of adipose accumulation for erectile dysfunction. METS-VF metabolism score for visceral fat, WC waist circumference, LAP lipid accumulation product, VAI visceral adiposity index, WHtR waist-to-height ratio

Fig. 6

Results of the mediation effects analysis. METS-VF metabolism score for visceral fat, SII systemic inflammation index, CI Confidence interval